A Timely Need

The Cleveland branch’s recent opening was spurred by several close calls due to a lack of understanding how a medical emergency should be handled on Shabbos. Rather than promptly calling 911, at times people would first knock on doors looking for a doctor or nurse to ask if the situation warranted a phone call on Shabbos. (Note: safek pikuach nefesh trumps Shabbos — if someone is in medical distress, call for help!) The breaking point was a couple years ago, when in a medical emergency, family members tried to find a local doctor and, when unsuccessful, waited until after Shabbos to make the phone call. Sadly, the patient suffered irrevocable damage because of the delay in treatment.

While attempts were made to start Hatzalah branches — including one by Rabbi Moshe Garfunkel a”h, the rav of the local shul Zichron Chaim — Cleveland’s population of 600 to 700 families were spread out over the greater area, which made the plans unfeasible. But in 2012, Ohio expanded its school voucher program — and the frum world took notice. Migration to Cleveland sped up come Covid, and today the community numbers roughly 2,000 families strong and growing.

Between the population explosion and the growing realization that relying on 911 wasn’t working anymore, Cleveland rabbanim began seriously contemplating opening a local Hatzalah. After several false starts, things took off in 2023 when Rabbi Nissim Abrin, the rav of Bais Avraham, tapped local businessman Shea Roth, vice president of operations of Arzel Zoning Technology; Michoel Bloom, who had experience serving with Hatzolah of Los Angeles; and Shmuel Kessler, an IT whiz, to form the operations committee for the nascent Cleveland Hatzalah branch.

On the other side of Lake Erie, Detroit also joined the list of out-of-town communities featuring its own Hatzalah in fall 2017. Nachy Soloff, a New York native who moved to Detroit after his marriage in 2007, was in for a rude awakening when he learned that Detroit didn’t have a local Hatzalah branch — he was from Monsey, where Rockland Hatzalah has been serving the community for half-a-century.

While today the city’s shuls and schools are bursting at the seams with new arrivals, it was a different story 18 years ago. Young couples were moving to locales with more opportunities, and the community of 800 families wasn’t big enough to support a local branch. Determined to address the issue of its shrinking population, Detroit askanim lured young yeshivish families with offers of well-paying kollels and (then) cheap housing. The incentives worked, and today the community boasts over 2,000 families, a 150 percent jump in growth in a span of about 15 years.

And every new arrival questioned why there wasn’t a community Hatzalah.

“While there was no traumatic incident that led to a rallying cry to start our own branch, there kept being cases where Hatzalah would have provided faster medical care than 911,” relates Mr. Soloff, who works in property maintenance and is the director of Detroit’s Hatzalah branch.

Talks began in earnest in late 2015, when longtime residents Mr. Bentzi Oseroff and Mr. Shmuel Bass met with the city of Southfield and realized this tremendous undertaking would demand more involvement by others in the community. The first step was to get all of the local rabbanim on board (a necessary prerequisite for any city wishing to be part of the larger Hatzalah organization umbrella). The Hatzalah team met with every rav in the community, and based on their critical feedback and ideas, protocols and operating procedures began to take shape.

Chicago Hatzalah members, fellow out-of-town trailblazers who had gotten their operation up and running in 2009, were instrumental in guiding the Detroit team, walking them through the steps to form a branch and helping craft the pitch about Hatzalah’s capabilities and benefits. They were all too familiar with the challenges Detroit would face, especially when they’d have to introduce the concept to skeptical government officials, and were happy to offer the benefit of their hard-earned experience.

After nearly a decade of operations, Chicago understood the system. They knew that a pitch from an outsider, no matter how polished or persuasive, would do nothing to allay municipal concerns; reassurance had to come from a peer. So the Detroit team, guided, directed, and assisted by local philanthropist Mr. Gary Torgow, arranged for Oak Park’s director of public safety and public manager and Southfield’s fire chief and EMS captain to fly to Chicago to meet the commissioner of the Chicago Fire Department and their EMS director — and it was a great success.

“The Chicago representatives were able to explain the process and benefits of a relationship on a peer-to-peer level, in a way that we never could,” Mr. Soloff says.

Detroit Southfield and Oak Park officials were convinced of Hatzalah’s value and ready to move forward. Years down the line, as an established and successful branch, Detroit was able to pay the favor forward; Cleveland’s first meeting with the municipality’s EMS heads wasn’t entirely successful, and before their second, higher-stakes session, Cleveland’s Mr. Shea Roth reached out to Mr. Soloff, who in turn brought the EMS captain of Southfield’s fire department to speak. It was a good move.

“She started the meeting by admitting that she was originally one of the Detroit team’s biggest detractors — she was worried that Hatzalah would make medical errors and steal union jobs — but over time, became their biggest fan and advocate,” Mr. Roth says.

Roadblocks and Politics

For out-of-town Hatzalahs, the road to legalization is rarely easy. Unlike in New York, where Hatzalah has been serving residents for 60 years and is an integrated city agency, out-of-town branches need to start with the basics, introducing the concept of a communally run and funded EMS service and combating skeptical unions and municipalities for the necessity to exist.

While Chicago was instrumental in Detroit’s legalization, the process was by no means easy. Unlike many states, Michigan doesn’t have a centralized state EMS office; each county has its own. That meant Hatzalah needed permission to operate from each individual municipality and medical control authority before receiving county and state licensure — and the requirements are not standardized.

The key difference between the cities is that Southfield has unionized fire and EMS agencies, while Oak Park outsources their EMS coverage. This crucial detail defines the relationship that Hatzalah has with their agencies, as well as the services they can provide. Coming to an agreement with Oak Park was easier than Southfield, which had a more codified process and department.

After months of negotiation, both Oak Park and Southfield gave Hatzalah the green light to operate — with a key caveat: They could not provide transport. This was the status quo for the first six years, and only began to chafe post-Covid once EMS agency staffing issues became a really challenge.

“We would get a call, and respond in 90 seconds — our target response time,” says Mr. Soloff. “Our team would stabilize and prep the patient for the hospital, but then we would have to sit around and wait 15 minutes for the local ambulance to show up.”

Mr. Soloff remembers the particular call where the issue came to a head. Alliance Mobile Health, the company Oak Park had contracted with to handle its EMS department, was struggling to retain EMTs. (It’s an emotionally draining job that isn’t compensated well; an Amazon warehouse worker can make more than an EMT, whose average pay is $20 an hour.) Naturally, the staff shortage was affecting ambulance response times.

“I was at a call — a serious call — and I waited on the scene for an hour until the ambulance showed up,” Mr. Soloff says. “And you know who was driving the ambulance? Alliance’s general manager. No one else was available to come. He was assisted by an EMT whose main job was working in the marketing department.”

Similar cases started piling up, until the situation reached the ears of Oak Park deputy public safety director Shawn Tetler. He came to the Hatzalah office to find out why they weren’t transporting the patients they treated to the hospital. When the team showed him the operating agreement, which explicitly stated that Hatzalah can only provide first response but not transport, he scoffed and tossed it out.

After notifying and getting approval from the Southfield fire department and Alliance Mobile Health, Detroit Hatzalah started transport in Oak Park last year. The ease of Oak Park’s sign-off was a real surprise. But unbeknownst to Hatzalah, Alliance Mobile Health was in discussions about selling their company to another EMS provider, so when they were approached for approval for Hatzalah’s transport rights in Oak Park, they readily agreed, as they were planning on phasing out their service there anyway.

Moving Things Along

Detroit isn’t the only branch that found transport an issue of contention; Hatzalah South Florida’s struggle to obtain a transport license made national news. Until housing prices caught up to the Tristate area, Florida was the main destination for the great migration, and Hatzalah had to expand just to keep up. Prior to Covid in 2020, they had 60 members covering seven neighborhoods; currently they have more than 300 (many of whom were Hatzalah members in their previous locations) providing coverage for 15 neighborhoods.

Before Covid, Hatzalah South Florida’s highest annual call volume record was 800 calls a year, but during the first year of the pandemic, it ballooned to 2,000. It was a catastrophic time, and the stress was exacerbated by the fact that Hatzalah was not legally allowed to provide transport. What was once an inconvenience was now affecting patient outcomes, and after the dust settled, the organization was determined to effect a change.

It wouldn’t be easy; local interests run the show in Florida. Prior to June 2021, in order for an EMS service to legally transport a patient to the hospital, they needed a “certificate of public convenience and necessity” from the fire department in every county of operation — and Florida’s fire departments have rejected every petition attempt since the early 1900s.

When Mr. Andre Roitman, a wealth manager at Valley Bank and the interagency relationship coordinator of Hatzalah South Florida, reached out to the union president, the blunt response was that no outside agency in the history of the state was ever given the right to transport, and Hatzalah wasn’t going to be the first.

Mr. Roitman was not deterred.

“If this was my agency, maybe you would be right,” he responded. “But Hatzalah is G-d’s agency, G-d’s organization, and He’s the one who will be making the call whether or not we will be transporting.”

When local attorney Raquel Rothman learned of Hatzalah’s difficulty obtaining the transport certificate, she called Mr. Roitman to offer her services pro-bono.

“The time is now to get this done,” she said to Mr. Roitman, who barely knew her at the time, but felt she was Heaven-sent and the right leader to head the effort.

Ms. Rothman quickly assembled a legislative team and worked with Hatzalah’s Mr. Aaron Gewirtz to draft the proposed bill that would finally provide the legal basis for Hatzalah to obtain its transport license.

Hatzalah began lobbying Tallahassee in 2021, and their campaign resonated with lobbyists and political activists who rallied for the cause. Political activist Lidya Abramovici was so impressed with Hatzalah that she offered them her spot in Senator Jason Pizzo’s calendar — a meeting she had been waiting four months for. The meeting was a game changer; Senator Pizzo, rumored to be a 2026 Democratic gubernatorial contender whose district covered many Jewish neighborhoods, was sympathetic.

“You don’t need to tell me about Hatzalah,” he said. “I know all about your Jewish laws. Let’s get this done!”

Senator Pizzo undertook the effort to get the votes in the state senate, and Republican representative Mike Caruso did the same in the state house.

What the Hatzalah team didn’t know was that there was a colossal behind-the-scenes effort by several special-interest groups to bury the “Jew bill” and make sure it never saw the light of day. In order for a bill to be brought up for a vote in Florida, it needs to pass through one senate and one house committee. Whenever there’s a bill that the legislature wants to quash without discussion, they use the unofficial “kill the bill process,” where they require it to pass through four committee meetings in one chamber before being brought to a vote on the floor. Bills that go through this route inevitably lose momentum and die a quiet death.

When the team heard the Hatzalah proposal was on the “kill the bill” path, they anxiously reached out to Senator Pizzo, who urged them, “Do your part, and Hashem will do His.” (Yes, he said “Hashem.”)

At the first senate committee meeting, the opposition, confident that the kill-the-bill tactic would do its job, didn’t show. Hatzalah presented their position, and with no one there to present the opposing side, the bill passed by default. Afterward, Senator Pizzo convinced the rest of the senators to cut the second meeting requirement. In a matter of hours, the Hatzalah bill went from having to pass four committees, to three — with only one remaining.

Completely unprepared, the opposition scrambled to concoct a compelling counterargument, but it was too late. The bill sailed through the House, and transport rights were granted to EMS agencies that have existed for ten years without transport and at least 50 responders.

Hatzalah was the only EMS agency that qualified.

“In a total neis, their method to hurt us ended up being the method for our yeshuah,” remembers Mr. Roitman of the emotional moment.

After the vote, the union president approached Mr. Roitman.

“He shook my hand and said, ‘The moment you brought your G-d into our phone call, I knew you would get what you needed,’ ” Mr. Roitman remembers.

Two weeks after Governor Ron Desantis signed Florida Senate Bill 1084/House Bill 805 in the Bal Harbour shul in June 2021, the Champlain Tower condominium building in Surfside collapsed. While surveying the site, he stopped by the large EMS base camp and was shocked to see who was running it.

“Hatzalah? But I signed your bill two weeks ago! How are you already operational?” the governor said, a brief moment of levity in a tragic situation.

Hatzalah stayed in Surfside for three weeks doing support work for the search-and-rescue units and supporting the families of the victims.

A key part of the law was Hatzalah’s concession not to receive any government funding or grants and to rely only solely on charitable donations. However, they plan to attempt to renegotiate this provision of the law due to ever-increasing demand; Hatzalah South Florida responded to a record-breaking 8,000 emergency calls in 2024.

Pulling Strings from Above

Cleveland’s route to going live saw a lot of Heavenly assistance as well. After getting the rabbinic green light to form a Hatzalah, the Cleveland operations committee started to look for someone to train responders. They approached University Hospitals, one of the larger medical systems in the state, to see if their EMS department would be interested.

Dr. Daniel Simon, the chief scientific officer and president of academic and external affairs, was immediately on board. A cardiologist by training, he has spent his career advocating for the need for quicker responses for cardiac emergencies and was blown away by the idea of a community-embedded emergency response team.

He put them in touch with University’s EMS director, Mr. Dan Ellenberger, and told him, “You need to make this happen, give them whatever they want.”

Mr. Ellenberger created a customized training course for the Hatzalah team, scheduling the classes to avoid conflicts with Yamim Tovim, Chol Hamoed, and midwinter vacation. Once, the instructors even moved the class to the same building as the Bikur Cholim dinner so members could attend both.

That’s not to say University went easy on the team — their course was longer and more intensive than other EMT courses. They were the first cohort ever to finish with a 100 percent pass rate, and after graduating, the team learned that University had decided to waive the cost, so they didn’t owe a cent for the training.

University also gave the team opportunities to gain hands-on experience by volunteering with their official response teams for different events like state fairs and every NFL Cleveland Browns home game. But their training showed its value even before the team went live, as they practiced mock calls and scenarios.

One time, Hatzalah captains Shragie Schiff and Elchanan Mantel wanted to reenact a three-car, head-on crash in which some patients were ejected on impact while others were trapped in their vehicles. Not wanting to attract too much attention, the group decided to stage the simulation late at night in an empty parking lot.

“So, it’s around 10 p.m., we’re staging the cars and having our ‘victims’ lie on the ground covered in a ton of fake blood… when suddenly the cops show up,” Mr. Roth shares.

Everyone froze.

Mr. Roth explained what was going on, and on a whim, invited the police to join.

“They were thrilled,” he laughs. “I guess they were really bored. They waited until we started and then pulled into the lot with their sirens blazing.”

Afterward, the cops complimented the team on their performance and said that they looked forward to working with them in the future.

In another mock call, the “patient” was an elderly man living with an aide who allowed the team to practice taking his vital signs. But when they arrived on scene and started taking his vitals, it became clear that he was in distress and actually having a medical emergency.

Cleveland Hatzalah also experienced remarkable Hashgachah when they set up their communications infrastructure. Standard walkie-talkie frequencies are compromised as parents across the country have been buying children expensive devices that allow them to listen in on or interfere with internal Hatzalah communications. Different branches are attempting to join an encrypted public safety radio frequency, which requires approval from the Federal Communications Commission, but when Elazar Broad from the Cleveland Hatzalah reached out last year, he was told the odds weren’t great.

“We sent in our paperwork and expected to receive a response after a few days,” Mr. Roth remembers. “Days led to months, and it was clear something was wrong.”

They waited and waited, but there was radio silence from the FCC.

Unsure of their next step, one of Cleveland’s volunteers suggested reaching out to their local senator for advice. On Thursday, November 14, 2024, Mr. Broad emailed their senator with a brief explanation of the problem, though he didn’t have high hopes for a response. The senator was on the busier side; J.D. Vance had just become the vice president-elect.

But they were happily surprised when the next morning, they got a response: Mr. Vance was working on it. Fifteen minutes before Shabbos, they got a phone call from the FCC. The only thing holding up the approval, they were told, was a missing document. By that Monday morning, they had their approval.

 Advice from the Trenches

The heart and soul of a community’s Hatzalah organization is its volunteers. But recruitment can be a challenge in a smaller community with a limited pool of member options. While it can be challenging to fill a full roster — a minimum of 20 EMTs, not including dispatch — Rabbi Starkman strongly recommends against chasing after people to join. In his experience, it won’t work out unless they really want to be there.

“If the only reason a guy finished the EMT program is because you called and texted him three times a day for a week, he’s not going to respond to calls once you’re live,” he says. “It must be out of a sense of love and service to the community.”

Round-the-clock coverage might sound simple, says Rabbi Starkman, but it doesn’t just mean that a few guys are available; it means a few capable, responsible, trained EMTs who will act in the patient’s interests and interact professionally with the ambulance company.

“It’s no small thing — we’re not putting together a minyan,” he cautions. “We’re putting together a medical organization that people are going to rely on, and the bar is significantly higher than I realized when I first started.”

In fact, Main Line postponed their original launch date of Chanukah 2024 to summer 2025 so they can train another class of EMTs.

Everyone agrees that “machers don’t make it,” as the saying goes. The thrill of 3 a.m. calls gets old really quickly, and that coveted red bag grows heavier after a month. If a member isn’t motivated by his sense of ahavas Yisrael and commitment to a greater purpose, he’s going to burn out.

Of course, the families have to be on board as well, which is why Rabbi Starkman urges prospective members to discuss the matter at length with their wives.

“When a man signs up for Hatzalah, it’s not only he who’s signing up, but his whole family — specifically his wife,” he says. “His wife is the one who is really making the sacrifice, holding down the fort while he gets to run out to be a hero. She’s doing bedtime. She’s running the Pesach Seder with no advance notice.”

Mr. Soloff imparts two pieces of advice when it comes to raising children whose parents are involved in Hatzalah. Firstly, he says, learn hilchos Shabbos with them — Rav Moshe Feinstein considered this crucial to counteract the inadvertent desensitization to chillul Shabbos that may take place when children see their father being mechallel Shabbos for pikuach nefesh. Like many Hatzalah members around the world, Mr. Soloff learns hilchos Shabbos with his family during the Shabbos seudah.

Mr. Soloff’s second piece of advice is to teach children that Hatzalah calls are not grist for the mill. He won’t share anything with them, and if they come home from school sharing stories, he’ll deny any knowledge, which is standard practice in all Hatzalah families, especially in small communities, where everyone knows everyone.

“If someone knows that their medical emergency will be the talk of the produce aisle, they won’t call for help when they need it,” he advises.

Another common but unanticipated struggle once an out-of-town branch goes live is low call volume. It’s a paradox, says Mr. Soloff.

“Low call volume is technically a good thing — we want everyone to stay healthy. But calls are how you stay skilled and practiced.”

EMS services are referred to internally as a “perishable skill”; if members aren’t regularly caring for patients, they’ll get rusty. While a regimented, regular training schedule is crucial — and mandated by Hatzalah leadership — it’s not the same as “practicing” on a real human body. (In fact, one of the first discoveries that volunteers experience in training is the visceral realization that human bodies feel significantly different from training dummies — they’re “squishy,” to use a medical term.)

Mr. Soloff recommends that Hatzalah members who want to maintain their skill set in the face of low call volume volunteer for 911 shifts. The Main Line team has taken this to heart, so much so that a local 911 call will occasionally draw a fully frum shift.

After years of planning and practice, Cleveland Hatzalah finally went live on January 21, 2025. In the months since then, they’ve heard from an assortment of both longtime and relatively new community members about how much more at ease they feel calling Hatzalah than 911, because they were worried about language barriers, unfamiliar procedures, the cost of emergency services, or simply whether their concern is “serious enough” for 911. Calling Hatzalah, on the other hand, feels more like calling a family member — because it is! Hatzalah operates within the community, staffed by volunteers who understand the culture, language, and nuances.

“We’ve had neighbors tell us they feel comfortable picking up the phone for small concerns or big emergencies alike, because they know the volunteers personally and trust that help will arrive swiftly and discreetly,” Mr. Roth relates proudly.

He describes a recent case to illustrate his point. After getting a call from a family about a patient in distress, Hatzalah immediately dialed 911 using a special extension for first responders. (This is their standard protocol, because they cannot provide transport; they need to notify 911 so there is an ambulance on hand once Hatzalah has provided initial treatment.)

When the Hatzalah dispatcher relayed the address, the 911 dispatcher responded in disbelief, “You want us to go there again? We left that address ten minutes ago!”

The Hatzalah crew rushed over and learned that the elderly patient — clearly in need of medical treatment — stubbornly refused to go to the hospital with 911’s EMTs, because he was “just fine.” The 911 team didn’t see the point in attempting to change his mind, and they left without him, after which the patient’s frantic family called Hatzalah.

Hatzalah had a long discussion with the patient, explaining what was going on and why he needed to be treated in a hospital. They were able to persuade him to get into the ambulance, a move that saved his life.

The family was incredibly grateful, and when things calmed down, the son reached out to Mr. Roth to thank him. He ruefully told Mr. Roth that his family was not an early fan of Hatzalah; he thought they were redundant because of 911 and a waste of communal resources.

Mr. Roth continues, “But when he helplessly watched 911 just leave his father behind and then witnessed the Hatzalah team refuse to quit until his father accepted medical intervention, his perception changed.”

This feedback meant a lot to the Cleveland Hatzalah team. Introducing an in-town mainstay to the infrastructure of their out-of-town community took years of detailed planning and incredible effort, and this encounter, only a few months after launch, reminded them why they do what they do — because new Hatzalah branches are already saving lives, one call at a time.

So you want to start a Hatzalah branch…

Do you feel like your community is ready for a Hatzalah branch but don’t know where to start? Here’s a partial list of what you need to do to get started:

• Call your LOR: Do the local rabbanim agree that a branch is necessary? Not only do you need rabbanim to answer the sh’eilos that come up daily, but rabbinic support is a prerequisite to using Hatzalah’s trademarked name.
• Assemble a team: Legal arrangements, technological setup, training, recruitment, and fundraising need to be resolved before your branch can go live, and a core group can help move the process along. Don’t worry if you don’t have coverage to handle every element from day one; if you can cover training, tech, and logistics, you have enough to get started.
• Call Hatzalah: By which I mean, Chevra Hatzalah— the national branch in New York. They have invaluable advice and resources, and as the trademark holders for the name “Hatzalah” in the United States, you will need their approval before being allowed to call yourself a Hatzalah branch.
• Call Hatzalah (again): Specifically, branches from communities of a similar size; they were once in your shoes and will be happy to help. While your branch needs to be customized to your communal situation, there’s no need to reinvent the wheel.
• Build your board: Your board of directors is your face to the community, and they will handle your fundraising. Many advise that your rav be a member of the board as well, with the bylaws stating that he has the final say in all matters.
• Confirm with the boss: Make sure every volunteer has cleared his decision to join with his wife; this has derailed more than one promising member.
• Schedule training: You will need a program that accommodates Shabbos and Yom Tov, which may take more time than you think.
• Fill the schedule: Before you go live, you need to make sure you have adequate coverage: At all hours of the day, you need at least two people who are ready to respond, and at least one person who is available to do dispatch. (Assuming dispatch takes daily three-hour shifts, you need eight people per day, or 56 people per week assuming everyone does one shift per week.)
• Sit tight: It will take longer than you think; the average time frame from conception to “we’re live” is about two years.

So you want to call yourself Hatzalah…

While anyone can start an EMT organization and call themselves “Ron’s Rescue Squad,” using the name “Hatzalah,” which is trademarked by Chevra Hatzalah in New York, is more complicated. To legally call yourself a Hatzalah branch, you need to pass an audit by meeting this list of standards:

• Is there a Vaad Harabbanim? Are the communal Orthodox rabbanim on board? Will someone provide halachic guidance to the branch? This is nonnegotiable.
• Is there communal support? Each branch is responsible for their own fundraising, and their primary donor base is the community they serve.
• Is there a qualified medical professional who can serve as a medical director for your branch? Chevra Hatzalah’s medical director needs to approve of the community’s medical director.
• Are all the legal documents filed correctly? Has the branch received all the necessary permits?
• Who are the members? Each branch has a captain in charge of recruitment and day-to-day operations, and Chevra Hatzalah relies on these branch captains to screen prospective members. A captain’s background check will look into the following: Does the applicant have a clean driving record? Is he mature enough to handle lights and sirens? Using your siren to beat Boro Park traffic is a no-no. Aside from putting lives at risk from reckless driving, cameras are everywhere, and the last thing anyone needs is a clip of a Hatzalah member going viral for the wrong reason. Can he exercise discretion? Breaching patient confidentiality is cause for dismissal; Hatzalah witnesses a person’s most private and vulnerable moments, and if the patient feels like his emergency will be the talk of the coffee room, he won’t call for help.

Ever wonder…

Why there are so many different spellings of Hatzalah (or Hatzoloh or Hatzolah)? According to Central Hatzalah, various branches started in several areas independently and per-need, which led to differences in spelling. All of the spellings are trademarked.

“We spell it Hatzalah, but we welcome all versions,” they say. “Not a big deal, and we actually have some fun with it.”

Focusing on mental health

For providers: Hatzalah volunteers can rush to a call with little advance warning of what they will encounter, so it’s not uncommon for them to be exposed to traumatic situations without adequate preparation. Hatzalah has protocols in place, created in tandem with the experts at Chai Lifeline, to help their members process various situations and protect their mental health. For starters, there will never be fewer than two members assigned to a call, so all EMTs have immediate support. After especially traumatic calls, the volunteers have a follow-up discussion with their team captain to make sure everyone is okay, as well as a quick check-in a few days later. When a member is part of a case that is too painful to quickly shake off — such as something involving a young child who is severely wounded or a patient who doesn’t survive — Hatzalah has trained experts on-hand to provide intervention for post-traumatic stress disorder (PTSD).

For patients (and their families): Hatzalahs nationwide are joining a new initiative to help patients and their families handle trauma and mental health in an emergency. To be clear, Hatzalah is not providing psychiatric care or diagnostics. Rather, they are employing Psychological First Aid (PFA), a pioneering approach developed in the early 2000s to help individuals in the immediate aftermath of a traumatic incident such as an abusive situation or a horrific car crash involving multiple victims. What makes PFA especially powerful is that it was created for use by non-mental health professionals, such as first responders and trained volunteers. By teaching these crucial skills to the people who are first on the scene, PFA aims to provide early emotional support and reduce the lasting impact of traumatic events. Hatzalah branches nationwide use programs modeled on the one created by Ichud Hatzalah in Eretz Yisrael, who discovered that intervention within the first few hours of a traumatic incident can drastically decrease the chances of survivors and witnesses developing PTSD.

This initiative has been quietly in place for New York and New Jersey Hatzalahs for years, and out-of-town branches are now starting to institute them as well.

(Originally featured in Mishpacha, Issue 1057)